Whether it’s the ancient Egyptians’ belief that dreams are the gods communicating with us, or a more modern theory — that dreams may hold the secret to curing neurodegenerative diseases like Alzheimer’s, Parkinson’s and dementia — we’ve been trying to understand what happens when we fall asleep for thousands of years.
“There has been a pretty wild notion that dreaming is a manifestation of your subconscious and that it’s an expression of unresolved conflicts one had during the day,” said Dr. Alon Avidan, director of UCLA’s Sleep Disorder Center and professor of neurology at UCLA, but the evidence from studies conducted at UCLA’s Sleep Laboratory isn’t conclusive.
“It’s interesting because, nowadays, dreams are recognized as hallucinatory experiences that the interpreter tries to put some meaning behind,” Avidan said. “But there is very little or not enough data to show this is an expression of any subconscious experience — so perhaps we’re putting too much meaning into what the dreams mean.”
Nightmares could come more often when somebody has undergone a traumatic event, Avidan said. “After 9/11, people were experiencing a high occurrence of nightmares, so it’s probably a window into one’s stress level, if they’re an adult.”
Individuals may also feel like they’re in a nightmare if they’ve experienced terrifying hypnagogic hallucinations, which are more commonly known as sleep paralysis — when a person feels like they’re fully awake but can’t move, according to Avidan.
“In most patients, it’s related to sleep deprivation,” Avidan said. “There have been some myths and explanations attached to this on social media like alien abduction theories, where individuals lose all concepts of space and time so they think they were taken hostage on an alien ship. But really, the physiologic explanation is when people wake up, but they are still technically asleep so they’re paralyzed.”
But not all dreams can be dismissed as hallucinations, according to Avidan.
“I’ve come to understand there are certain dream experiences that may point toward more significant or clinical conditions or disorders that we as clinicians need to be more concerned about,” Avidan said, before sharing the specifics of REM sleep behavior disorder, or RBD.
“It’s very, very interesting because (REM sleep behavior disorder) may put one at risk for a neurodegenerative disease later in life,” Avidan said, explaining how RBD is similar to sleepwalking, but a much more extreme form of parasomnia.
“Without a doubt, the question I am most often asked by reporters, inquirers, students and most people everywhere who discover that I study dreams is, ‘What do my dreams mean?’”
Patrick McNamara states on his website Dream Catcher. “Even if dreams do carry some meaning (and I believe that they do), no one has any validated method for reliably extracting those meanings from any given dream.”
Usually when one is sleeping, their muscles are paralyzed but patients diagnosed with RBD can often be seen punching, kicking, screaming or trying to to swat bees, hit a ball or fight all while dreaming, Avidan said. “But the problem with RBD is that it often leads to injury, because we’ve heard of patients of punching the wall or punching their spouse or lifting a heavy dresser and suffering serious fractures to the skull.
“RBD is also a sign that somebody may be at risk or is susceptible for neurodegenerative diseases, like dementia or Alzheimer’s,” Avidan said. “So when patients begin to act out their dreams, in about 10 years, two-thirds of them will develop Parkinson’s Disease, and the longer it continues, the more likely people are to develop other neurodegenerative diseases.”
This is why Avidan and other clinicians at the UCLA sleep lab are looking to develop a medication or therapy that can help patients before they develop the neurodegenerative diseases.
“It’s a window of opportunity and it’s based on the diagnosis of dreams,” Avidan said. “It’s too late to cure it once they develop the disease, so we want to begin to try to intervene to delay or prevent the conversion later in life to dementia. That’s why this (dreaming) clue is really, really important, because we may finally be able to develop a medication for dementia.”
It’s like having fair skin and being susceptible to getting skin cancer, Avidan said. You can put on sunscreen to protect you, which is what the prospective therapy or medication would seek to do.
“It’s really bizarre and interesting and patients always ask, ‘Where do we go from here?’ But that’s a million-dollar question,” Avidan said. “I think we must find out if we can we take a medication to prevent the onset of neurodegenerative disease before we find out what’s next.”
Currently, there is a clinical trial at UCLA trying to understand RBD patients, and if there are other conditions, such as loss of smell, depression or constipation that could patients at a higher risk of contracting neurodegenerative diseases as opposed to somebody who just has RBD.
“We can speak for hours on that, really,” Avidan said, “but we’ll just have to see.”